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However, the seasonal subunit vaccination response is frequently suboptimal, and alternate more efficient vaccination systems must be examined. We compared the immunogenicity of an adjuvanted virosomal influenza and subunit vaccine in <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The immunogenicity after a single dose (0.5\u00a0mL) of adjuvanted trivalent virosomal vaccination was evaluated in a study cohort of 21 <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> recipients and compared to a control cohort of 30 <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> recipients who received a single dose (0.5\u00a0mL) of non\u2010adjuvanted seasonal trivalent subunit vaccination over 4 seasons from 2010 to 2014. Whole blood interferon\u2010gamma (<jats:styled-content style=\"fixed-case\">IFN<\/jats:styled-content>\u2010\u03b3) release assays were tested, both before and 30\u00a0days after vaccination, in response to influenza pandemic (pdm) H1N1, H3N2, and B antigens. <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010A*02 dextramers, to gauge for the absolute number of antigen\u2010specific <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>8<jats:sup>+<\/jats:sup> T\u2010cells, and pdm 2009 hemagglutinin inhibition (<jats:styled-content style=\"fixed-case\">HI<\/jats:styled-content>) assays, to test for neutralizing antibodies, were used as immunological readouts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The pdm <jats:styled-content style=\"fixed-case\">HI<\/jats:styled-content> titers were poor in both cohorts with only 23% (5\/21) after virosomal vaccination and 13.3% (4\/30) in the seasonal vaccine cohort having protective titers (\u226540). The delta change of <jats:styled-content style=\"fixed-case\">IFN<\/jats:styled-content>\u2010\u03b3 production in response to influenza pdm H1N1 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.005) and influenza B antigens (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) were significantly elevated in blood from individuals who received the virosomal as compared to the seasonal vaccine. The <jats:styled-content style=\"fixed-case\">IFN<\/jats:styled-content>\u2010\u03b3 response to pdm H1N1 was stronger (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), as compared to seasonal vaccination, in patients vaccinated &gt;6\u00a0month post <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content>. We detected a significant increase in the frequency of matrix 1 (<jats:styled-content style=\"fixed-case\">GILGFVTL<\/jats:styled-content>) dextramer\u2010specific <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>8<jats:sup>+<\/jats:sup> T\u2010cells after the virosomal vaccine (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01). No differences were seen in the hemagglutinin\u2010specific <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>8<jats:sup>+<\/jats:sup> T\u2010cells between the 2 cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Vaccination using a virosomal delivery system is beneficial in eliciting robust cellular immune responses to pdm H1N1 influenza in <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12382","type":"journal-article","created":{"date-parts":[[2015,3,29]],"date-time":"2015-03-29T07:08:25Z","timestamp":1427612905000},"page":"371-379","source":"Crossref","is-referenced-by-count":20,"title":["Immunogenicity of virosomal adjuvanted trivalent influenza vaccination in allogeneic stem cell transplant recipients"],"prefix":"10.1111","volume":"17","author":[{"given":"A.","family":"Ambati","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Karolinska Institutet Huddinge Sweden"},{"name":"Department of Medicine Karolinska Institutet Huddinge Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Einarsdottir","sequence":"additional","affiliation":[{"name":"Sahlgrens University Hospital Goteborg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Magalhaes","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Karolinska Institutet Huddinge Sweden"},{"name":"Center for Allogeneic Stem Cell Transplantation Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Poiret","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Karolinska Institutet Huddinge Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Bodenstein","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine 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